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Small-Scale Question Sunday for December 31, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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That's the study I was referencing that shows that telling people to wear masks doesn't seem to do a lot. It's really hard to do a study on whether consistent mask use works because virtually everyone falls into one of two groups:

  1. Won't mask consistently.
  2. Will mask consistently anyway.

And furthermore, there's social desirability bias on telling a researcher studying masking that you're in group (2) if they are having you wear masks for a study.

One study included in the Cochrane review (well, the data at least) addressed the difference between 1000+ medical professions treating covid-19 patients randomly selected into surgical and n95 masks and it didn't find a statistically significant difference between the groups. This design significantly reduces the danger of the social desirability bias effect you're talking about, but still relied on self-report for adherence to the assigned mask-type and wearing consistency, however randomization should reduce that effect, too. There were 4 others with similar results in different settings (1 found weak effect).

So perhaps you believe that the available evidence doesn't adequately account for the the issue of self-report when comparing mask vs no mask, but then why do you also believe N95 masks are better than surgical masks when there is either no or very weak evidence it makes a difference?

If your belief about how viruses mechanistically transmit between humans is true and the N95 directly addresses this concern to a much higher degree than surgical or cloth masks, why wouldn't we see stronger evidence of a difference when in people testing positive with influenza-like-illness?

It's intuitive that masks do something, but they also have other effects which could wash out the possible reduction in the mechanistic transmission you discussed above in another comment.

why do you also believe N95 masks are better than surgical masks when there is either no or very weak evidence it makes a difference?

I have not carefully reviewed the literature myself. I'm following what expert science communicators claim the literature says, as I expect them to be better identifying the flaws in studies and understanding what they actually say.

I agree that study result you linked is surprising. I guess it implies that either the masks are equivalent in quality in this setting or that masking had no measurable effect, most likely due to transmission at work being a rounding error compared to community transmission. Or something else is going on that I don't know to look for.